Dry Mouth

What is saliva?

Saliva, or spit, is made by your salivary glands. It helps keep you and your mouth healthy. For example:

• It moistens and breaks down the foods you eat, which makes it easier for you to chew and swallow.
• It washes away small food pieces from your teeth and gums, which helps fight against tooth decay.
• It contains minerals such as calcium and phosphate, which can also help fight tooth decay.
• It contains antibodies that can fight against infections of the mouth and throat. Antibodies are proteins that your immune system makes to fight foreign substances such as viruses and bacteria.

What is dry mouth?

Having dry mouth, also called xerostomia, means that you don't have enough saliva to keep your mouth wet. Everyone has a dry mouth once in a while, like when you are nervous or stressed. But if you have a dry mouth all or most of the time, it can be uncomfortable. It can make chewing, swallowing, and even talking difficult. It also raises your risk for tooth decay or infections in the mouth.

What causes dry mouth?

There are many possible causes of dry mouth, including:

• Side effects of certain medicines, such as some medicines for high blood pressure, depression, and bladder-control issues
• Diseases such as Sjogren's syndrome, HIV, salivary gland disorders, and diabetes
• Radiation therapy, which can damage your salivary glands if they are exposed to radiation during the treatment
• Chemotherapy, which can make your saliva thicker and cause your mouth to feel dry
• Nerve damage, when it involves the nerves that tell salivary glands to make saliva
• Breathing through your mouth
• Use of alcohol, tobacco, or other substances

What are the symptoms of dry mouth?

The symptoms of dry mouth may include:

• A sticky, dry feeling in your mouth
• Trouble chewing, swallowing, tasting, or speaking
• A burning feeling in your mouth
• A dry feeling in your throat
• Cracked lips
• A dry, rough tongue
• Mouth sores
• An infection in your mouth
• Bad breath

How is the cause of dry mouth diagnosed?

If you have dry mouth, it's important to find out the cause. To do that, your health care provider or dentist will review your medical history, examine your mouth, and ask about any medicines you take. They may also suggest blood tests or a test that measures how much saliva you produce.

What are the treatments for dry mouth?

Treatment for dry mouth depends on the cause. For example, if a medicine is causing dry mouth, your provider or dentist may suggest adjusting the dosage or switching medicines. In some cases, they might give you artificial saliva or a medicine to help your salivary glands work better.

There are also several things you can do to help relieve your symptoms:

• Drink plenty of water
• Avoid drinks with caffeine, which can dry out your mouth
• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow
• Avoid spicy or salty foods because they can cause pain if your mouth is dry
• Avoid alcohol and tobacco
• Using a humidifier at night
• Use a mouthwash made for dry mouth

Since dry mouth can raise your risk of tooth decay, it's important to brush and floss your teeth regularly and see your dentist at least twice a year.

NIH: National Institute of Dental and Craniofacial Research

Eye Care

Why does eye care matter?

Eye care is about keeping your eyes healthy through good daily habits, regular checkups, and treatment when needed. Your eyes are an important part of your health. You rely on them every day to see and understand the world around you. Some eye diseases can lead to vision loss without early warning signs, so it's important to catch them as soon as possible. Get your eyes checked as often as your health care provider recommends, or if you notice new vision problems. Just like caring for the rest of your body, it's important to keep your eyes healthy.

How can I keep my eyes healthy?

There are many things you can do to protect your eyes and see your best:

• Give your eyes a rest. Spending long hours on a computer or other digital screens can make you blink less, causing dryness and tired eyes. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.
• Wear sunglasses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100% of both UV-A and UV-B radiation.
• Wear protective eyewear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
• Avoid rubbing your eyes. Rubbing your eyes can transfer dirt and bacteria that may cause irritation or lead to an infection.
• Use good lighting. Brighten your space to reduce strain and help you see comfortably.
• If you wear contacts, take steps to prevent eye infections. Wash your hands before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them and replace them when needed.

How can my nutrition and lifestyle habits affect my eye health?

What you eat and how you take care of your body can have a big impact on your eyes and vision:

• Eat a healthy, balanced diet. Your diet should include plenty of fruits and vegetables, especially dark leafy green vegetables like spinach, kale, or collard greens. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
• Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
• Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. Regular exercise helps lower your risk.
• Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
• Know your family medical history. Some eye diseases are inherited (passed down through families), so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
• Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know your risk factors because you may be able to lower your risk by changing some behaviors.

What's the difference between an eye test and an eye exam?

Everyone needs their eyesight tested to check for vision and eye problems. Children usually have vision screening, also called an eye test, in school or at their provider's office during a checkup. This is a brief test that mainly checks how well you can see things up close and far away. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.

Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.

The eye exam includes several tests:

• Test your side (peripheral) vision with a visual field test. Losing peripheral vision may be a sign of glaucoma.
• Check how well you see at various distances with a visual acuity test, where you read an eye chart about 20 feet away.
• Follow an object with your eyes during an eye muscle function test to check for problems with the muscles that control your eyes.
• Shine a light into your eyes with a pupil response test to see how your pupils react to light.
• Measure the pressure inside your eyes with tonometry. This test helps to detect glaucoma.
• Dilate (widen) your pupils with special eye drops allows more light to enter the eye. Your eye care provider then uses a special magnifying lens to clearly see important tissues at the back of your eye, including the retina, macula, and optic nerve.

If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.

When should I start getting eye exams?

How often you need eye exams depends on your age, race, risk factors, and overall health. For example, Black/African American adults are at higher risk for glaucoma and may need to start exams earlier. If you have diabetes, you should have an exam every year. Check with your provider about when you need these exams.

See an eye care specialist right away if you have symptoms like sudden loss of vision, double vision, blurred vision with eye pain, flashes of light, black spots or halos around lights. These symptoms may represent a serious medical or eye condition.

Fatty Liver Disease

What is fatty liver disease?

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up in your liver. There are two main types:

• Nonalcoholic fatty liver disease (NAFLD)
• Alcoholic fatty liver disease, also called alcoholic steatohepatitis

What is nonalcoholic fatty liver disease (NAFLD)?

NAFLD is a type of fatty liver disease that is not related to heavy alcohol use. There are two kinds:

• Simple fatty liver, in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not get bad enough to cause liver damage or complications.
• Nonalcoholic steatohepatitis (NASH), in which you have inflammation and liver cell damage, as well as fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer.

What is alcoholic fatty liver disease?

Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances. These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease. The next stages are alcoholic hepatitis and cirrhosis.

Who is at risk for fatty liver disease?

The cause of nonalcoholic fatty liver disease (NAFLD) is unknown. Researchers do know that it is more common in people who:

• Have type 2 diabetes and prediabetes
• Have obesity
• Are middle aged or older (although children can also get it)
• Are Hispanic, followed by non-Hispanic Whites. It is less common in African Americans.
• Have high levels of fats in the blood, such as cholesterol and triglycerides
• Have high blood pressure
• Take certain drugs, such as corticosteroids and some cancer drugs
• Have certain metabolic disorders, including metabolic syndrome
• Have rapid weight loss
• Have certain infections, such as hepatitis C
• Have been exposed to some toxins

NAFLD affects about 25% of people in the world. As the rates of obesity, type 2 diabetes, and high cholesterol are rising in the United States, so is the rate of NAFLD. NAFLD is the most common chronic liver disorder in the United States.

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time. The risk is higher for heavy drinkers who are women, have obesity, or have certain genetic mutations.

What are the symptoms of fatty liver disease?

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.

How is fatty liver disease diagnosed?

Because there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use:

• Your medical history
• A physical exam
• Various tests, including blood and imaging tests, and sometimes a biopsy

As part of the medical history, your doctor will ask about your alcohol use, to find out whether fat in your liver is a sign of alcoholic fatty liver disease or nonalcoholic fatty liver (NAFLD). He or she will also ask which medicines you take, to try to determine whether a medicine is causing your NAFLD.

During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs of fatty liver disease, such as:

• An enlarged liver
• Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow

You will likely have blood tests, including liver function tests and blood count tests. In some cases you may also have imaging tests, like those that check for fat in the liver and the stiffness of your liver. Liver stiffness can mean fibrosis, which is scarring of the liver. In some cases you may also need a liver biopsy to confirm the diagnosis, and to check how bad the liver damage is.

What are the treatments for fatty liver disease?

Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a certain medicine is the cause of your NAFLD, you should stop taking that medicine. But check with your doctor before stopping the medicine. You may need to get off the medicine gradually, and you might need to switch to another medicine instead.

There are no medicines that have been approved to treat NAFLD. Studies are investigating whether a certain diabetes medicine or Vitamin E can help, but more studies are needed.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.

Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

What are some lifestyle changes that can help with fatty liver disease?

If you have any of the types of fatty liver disease, there are some lifestyle changes that can help:

• Eat a healthy diet, limiting salt and sugar, plus eating lots of fruits, vegetables, and whole grains
• Get vaccinations for hepatitis A and B, the flu and pneumococcal disease. If you get hepatitis A or B along with fatty liver, it is more likely to lead to liver failure. People with chronic liver disease are more likely to get infections, so the other two vaccinations are also important.
• Get regular exercise, which can help you lose weight and reduce fat in the liver
• Talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.

Foot Health

Each step you take involves a complex network of bones, muscles, tendons, and ligaments. This, combined with all of the weight they carry, explains why feet can have problems. To keep your feet healthy:

• Examine your feet regularly
• Wear comfortable shoes that fit
• Wash your feet daily with soap and lukewarm water
• Trim your toenails straight across and not too short

Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure.

Good foot care and regular foot checks are an important part of your health care. If you have foot problems, be sure to talk to your doctor.

NIH: National Institute on Aging

Glaucoma

What is glaucoma?

Glaucoma is a group of diseases that can damage the optic nerve of one, or both, of your eyes. This can result in vision loss. There are different types of glaucoma, but the most common type is open-angle glaucoma. Other less common types include angle-closure glaucoma, and congenital glaucoma.

You may not have any symptoms of glaucoma. Regular eye exams by an eye care provider can check for glaucoma and other eye problems to help protect your vision. Treatments that lower eye pressure help slow the disease. Without treatment, glaucoma can eventually lead to blindness.

What causes glaucoma?

Medical experts aren't sure what causes glaucoma, but the most common types usually happen when the fluid pressure inside your eye slowly rises, damaging the optic nerve. Other types of glaucoma may be caused by medical conditions, or a baby may be born with it.

Not everyone with high eye pressure develops glaucoma. Some people may even get glaucoma with normal eye pressure. The amount of pressure your optic nerve can handle is different for each person. Getting regular dilated eye exams helps your provider figure out what level of eye pressure is normal for you.

What are the symptoms of glaucoma?

Often there are no symptoms of glaucoma at first. Or symptoms may start so slowly that you may not notice them. Without treatment, you slowly lose your peripheral (side) vision. It may seem like you're looking through a tunnel. Over time, your straight-ahead vision may decrease until no vision remains.

If you have sudden symptoms of intense eye pain, blurry vision, red eyes, or an upset stomach (nausea), you need to go to your eye care provider or an emergency room right away. These could be symptoms of angle-closure glaucoma. This less common type of glaucoma causes fluid to build up quickly in your eye.

How is glaucoma diagnosed?

A comprehensive eye exam can tell if you have glaucoma. This would include:

• A dilated eye exam. This involves getting eye drops that dilate (widen) your pupils. This allows more light to enter your eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye to check for glaucoma or other eye problems. For a few hours after the exam your vision may be blurry and sensitive to light, so you will need someone to take you home.
• Visual field testing. This check of your peripheral (side) vision allows your eye care provider to find out how well you can see objects off to the side of your vision without moving your eyes.
• Tonometry. This measures the pressure inside your eye.

If you're at higher risk for glaucoma, you should get comprehensive eye exams every one to two years. You're at higher risk if you:

• Are Black or African American and over age 40
• Are over age 60, especially if you're Hispanic or Latino
• Have a family history of glaucoma

You're also at higher risk if you have high blood pressure or diabetes and should get a dilated eye exam at least once a year. Talk with your provider about your risk and how often you should get your eyes checked.

What are the treatments for glaucoma?

Early treatment can help protect your eyes against vision loss. There is no cure, but glaucoma can usually be controlled. Without treatment it can eventually cause blindness. Treatments can include:

• Prescription eye drops are the most common treatment to lower the pressure in your eye and prevent damage to your optic nerve.
• Other treatments may include oral medicines, laser treatment, and/or surgery.

A combination of these treatments may be used to lower eye pressure and help drain the fluid out of your eye.

Can glaucoma be prevented?

There is no way to prevent glaucoma. Eye exams can help find glaucoma or other eye problems before they can affect your vision. If you have glaucoma, be sure to continue with treatment to prevent your vision from getting worse.

NIH: National Eye Institute